tbuckley/cabot-search huggingface dataset:
Tafamidis Efficacy Among Octogenarian Patients in the Phase 3 ATTR-ACT and Ongoing Long-Term Extension Study
Authors: Pablo Garcia-Pavia, Marla B. Sultan, Balarama Gundapaneni, Yoshiki Sekijima, Federico Perfetto, Mazen Hanna, Ronald Witteles
Journal: JACC Heart Failure (2023)

Tafamidis was approved to treat patients with transthyretin amyloid cardiomyopathy (ATTR-CM) on the basis of findings from the phase 3 Tafamidis in Transthyretin Cardiomyopathy Clinical Trial (ATTR-ACT). Post hoc analysis exploring tafamidis efficacy in octogenarian patients. Analysis of patients aged <80 and ≥80 years in ATTR-ACT and its ongoing open-label long-term extension (LTE) study, where all patients receive tafamidis. After 30 months in ATTR-ACT, least squares (LS) mean change from baseline in 6-minute walk test (6MWT) distance, N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentration, and Kansas City Cardiomyopathy Questionnaire Overall Summary (KCCQ-OS) score were smaller (all P < 0.05) in patients aged ≥80 years treated with tafamidis (n = 51) vs placebo (n = 37). At the LTE study interim analysis, patients aged ≥80 years treated continuously with tafamidis had a smaller decline in KCCQ-OS score (P < 0.05) and trended toward longer median survival (45 vs 27 months; all-cause mortality HR: 0.6828 [95% CI: 0.4048-1.1517]; P = 0.1526) than those initially treated with placebo in ATTR-ACT. Similar efficacy was observed in patients aged <80 years in ATTR-ACT, including smaller LS mean change from baseline in 6MWT distance, NT-proBNP concentration, and KCCQ-OS score, and lower rate of cardiovascular-related hospitalizations with tafamidis (n = 125) vs placebo (n = 140). In the LTE study, patients aged <80 years treated continuously with tafamidis had a longer median survival (80 vs 41 months; HR = 0.4513 [95% CI: 0.3176-0.6413]; P < 0.0001) and a smaller decline in KCCQ-OS score than those initially treated with placebo. The findings demonstrate tafamidis efficacy for patients with ATTR-CM both in those aged <80 and those aged ≥80 years. (Tafamidis in Transthyretin Cardiomyopathy Clinical Trial [ATTR-ACT]; NCT01994889/Long-term Safety of Tafamidis in Subjects With Transthyretin Cardiomyopathy; NCT02791230)
Patterns, Prognostic Implications, and Rural-Urban Disparities in Optimal GDMT Following HFrEF Diagnosis Among Medicare Beneficiaries
Authors: Amgad Mentias, Neil Keshvani, Andrew Sumarsono, Rohan Desai, Muhammad Shahzeb Khan, Venu Menon, Eileen Hsich, Adam P. Bress, Joshua Jacobs, Ramachandran S. Vasan, Gregg C. Fonarow, Ambarish Pandey
Journal: JACC Heart Failure (2023)
A Novel Heart Failure Diagnostic Risk Score Using a Minimally Invasive Subcutaneous Insertable Cardiac Monitor
Authors: Michael R. Zile, Rami Kahwash, Shantanu Sarkar, Jodi Koehler, Todd Zielinski, Mandeep R. Mehra, Gregg C. Fonarow, Sanjeev Gulati, Javed Butler
Journal: JACC Heart Failure (2023)

The authors tested the hypothesis that physiological information from sensors within a minimally invasive, subcutaneous, insertable cardiac monitor (ICM) could be used to develop an ambulatory heart failure risk score (HFRS) to accurately identify heart failure (HF) patients, across the ejection fraction spectrum, at high risk of an impending worsening heart failure event (HFE). The purpose of this study was to examine performance of ICM-based, multiparameter, dynamic HFRS to predict HFEs in patients with NYHA functional class II/III HF. In 2 observational cohorts, HF patients were implanted with an ICM; subcutaneous impedance, respiratory rate, heart rate and variability, atrial fibrillation burden, ventricular rate during atrial fibrillation, and activity duration were combined into an HFRS to identify the probability of HFE within 30 days. Patients and providers were blinded to the data. HFRS sensitivity and unexplained detection rate were defined in 2 independent patient population data sets. HFEs were defined as hospitalization, observation unit, or emergency department visit with a primary diagnosis of HF, and intravenous diuretic treatment. First data set (development): 42 patients had 19 HFE; second data set (validation): 94 patients had 19 HFE (mean ± SD age 66 ± 11 years, 63% men, 50% with LVEF ≥40%, 80% NYHA functional class III). Using a high-risk threshold = 7.5%, development and validation data sets: sensitivity was 73.7% and 68.4%; unexplained detection rate of 1.4 and 1.5 per patient-year; median 47 and 64 days early warning before HFE. ICM-HFRS provides a multiparameter, integrated diagnostic method with the ability to identify when HF patients are at increased risk of heart failure events. (Reveal LINQ Evaluation of Fluid [REEF]; NCT02275923; Reveal LINQ Heart Failure [LINQ HF]; NCT02758301; Algorithm Using LINQ Sensors for Evaluation and Treatment of Heart Failure [ALLEVIATE-HF]; NCT04452149)
Letter to the Editor: How to define the futile outcome in patients undergoing surgery for perihilar cholangiocarcinoma?
Authors: Zhi-Peng Liu, Xing-Hao Sun, Chao Yu, Xian-Yu Yin, Zhi-Yu Chen
Journal: Hepatology (2023)

1Department of Hepatobiliary Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China 2Department of Hepatobiliary Surgery, The Affiliated Hospital of Guizhou Medical University, Guiyang, China Zhi-Peng Liu and Xing-Hao Sun equally contributed to this work. Types of Articles: Letter to the editor. Correspondence: Zhi-Yu Chen, Southwest Hospital, Third Military Medical University (Army Medical University), No. 30, Gaotanyan Road, Chongqing 400038, China. Email: [email protected] This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0/
Rationale, Design, and Patient Characteristics of a Cluster-Randomized Pragmatic Trial to Improve Mineralocorticoid Antagonist Use
Authors: Katherine A.A. Clark, Angela M. Victoria-Castro, Lama Ghazi, Yu Yamamoto, Claudia Coronel-Moreno, Bashar Adel Kadhim, Ralph J. Riello, Kyle O’Connor, Tariq Ahmad, F. Perry Wilson, Nihar R. Desai
Journal: JACC Heart Failure (2023)
Navigating the “specific etiology” steatohepatitis category: Evaluation and management of nonalcoholic/nonmetabolic dysfunction–associated steatohepatitis
Authors: Mohammad Qasim Khan, Sara Hassan, Blanca C. Lizaola-Mayo, Mamatha Bhat, Kymberly D. Watt
Journal: Hepatology (2023)

Qasim Khan, Mohammad; Hassan, Sara; Lizaola-Mayo, Blanca C.; Bhat, Mamatha; Watt, Kymberly D. Author Information
OSATS scoring confirms ICG enhancement of performance in laparoscopic radical gastrectomy: a post-hoc analysis of a randomized controlled trial
Authors: Ze-Ning Huang, Qi-Chen He, Wen-Wu Qiu, Ju Wu, Chang-Yue Zheng, Guo-Sheng Lin, Ping Li, Jia-Bin Wang, Jian-Xian Lin, Jun Lu, Long-Long Cao, Mi Lin, Ru-Hong Tu, Chao-Hui Zheng, Qi-Yue Chen, Chang-Ming Huang, Jian-Wei Xie
Journal: International Journal of Surgery (2023)

Background: Indocyanine green (ICG) fluorescence imaging is effective in increasing the number of lymph node dissections during laparoscopic radical gastrectomy; however, no studies have attempted to explain this phenomenon. Methods: This study utilized the data from a previous randomized controlled trial (FUGES-012 study) investigating ICG-guided laparoscopic radical gastrectomy performed between November 2018 and July 2019. The Objective Structured Assessments of Technical Skills (OSATS) scoring system was used to grade videos from the ICG and non-ICG groups. Patients with an OSATS score &gt;29 were classified as the high-OSATS population, while those with an OSATS score ≤29 were classified as the low-OSATS population. Results: A total of 258 patients were included in the modified intention-to-treat analysis: 129 in the ICG group and 129 in the non-ICG group. The OSATS score of the ICG group was higher than that of the non-ICG group (29.6 ± 2.6 vs. 26.6 ± 3.6; P &lt;0.001). The ICG group underwent a significantly higher mean total number of lymph node dissections than the non-ICG group (50.5 ± 15.9 vs. 42.0 ± 10.3; adjusted P &lt;0.001). The group assigned to ICG use, better OSATS (high-OSATS) scores were observed, which correlated with greater D2 lymph node retrieval (54.1±15.0 vs. 47.2±8.7; adjusted P =0.039). Finally, the ICG group had a lower rate of lymph node non-compliance than that of the non-ICG group (31.8% vs. 57.4%; P &lt;0.001). Conclusions: By applying ICG fluorescence navigation technique, better OSATS scores were observed, which correlated with greater lymph node retrieval and lower lymph node non-compliance rate, as recommended for individualized laparoscopic radical gastrectomy.
Impact of Digital Health Technology on Quality of Life in Patients With Heart Failure
Authors: Angela M. Victoria-Castro, Melissa L. Martin, Yu Yamamoto, Hannah Melchinger, Jason Weinstein, Andrew Nguyen, Kyoung A. Lee, Brett Gerber, Frida Calderon, Labeebah Subair, Veronica Lee, Alyssa Williams, Melissa Shaw, Tanima Arora, Adriano Garcez, Nihar R. Desai, Tariq Ahmad, F. Perry Wilson
Journal: JACC Heart Failure (2023)

Digital health tools may improve quality of life (QoL) in patients with heart failure (HF) by promoting self-care, knowledge, and engagement.
Comparative effectiveness of noninvasive therapeutic interventions for myofascial pain syndrome: a network meta-analysis of randomized controlled trials
Authors: Chang Liu, Yang Wang, Wenli Yu, Junai Xiang, Guoyong Ding, Weihua Liu
Journal: International Journal of Surgery (2023)

Background: Myofascial pain syndrome (MPS) has an impact on physical health and quality of life for patients, with various non-invasive methods used for relieving myofascial pain. We aimed to compare the effectiveness of different non-invasive therapeutic interventions for MPS. Materials and Methods: We searched PubMed, Embase, CINAHL Complete, Web of Science, Cochrane, and Scopus to identify randomized controlled trials (RCTs) describing the effects of any non-invasive treatments in patients with MPS. The primary outcome was pain intensity, while pressure pain threshold and pain-related disability were secondary outcomes. Results: The analysis included 40 studies. Manual therapy (MD of pain: -1.60, 95% CI: -2.17 to -1.03; MD of pressure pain threshold: 0.52, 95% CI: 0.19 to 0.86; MD of pain-related disability: -5.34, 95% CI: -8.09 to -2.58), laser therapy (MD of pain: -1.15, 95% CI: -1.83 to -0.46; MD of pressure pain threshold: 1.00, 95% CI: 0.46 to 1.54; MD of pain-related disability: -4.58, 95% CI: -7.80 to -1.36)，extracorporeal shock wave therapy (MD of pain: -1.61, 95% CI:-2.43 to -0.78; MD of pressure pain threshold: 0.84, 95% CI: 0.33 to 1.35; MD of pain-related disability: -5.78, 95% CI: -9.45 to -2.12), and ultrasound therapy (MD of pain: -1.54, 95% CI: -2.24 to -0.84; MD of pressure pain threshold: 0.77, 95% CI: 0.31 to 1.22) were more effective than no treatment. Conclusion: Our findings support that manual therapy, laser therapy, and extracorporeal shock wave therapy could effectively reduce pain intensity, pressure pain threshold, and pain-related disability with statistical significance when compared with placebo. This finding may provide clinicians appropriate therapeutic modalities for patients with myofascial pain syndrome among different scenarios.
Optical Coherence Tomography Compared With Intravascular Ultrasound and Angiography in Complex Coronary Artery Lesions
Authors: Joo Myung Lee, Hangyul Kim, Jong-Young Lee, Ki Hong Choi, Young Bin Song, Seung-Jae Lee, Sang Yeub Lee, Sang Min Kim, Kyeong Ho Yun, Jae Young Cho, Chan Joon Kim, Hyo-Suk Ahn, Chang-Wook Nam, Hyuck-Jun Yoon, Yong Hwan Park, Wang Soo Lee, Jin-Ok Jeong, Pil Sang Song, Joon-Hyung Doh, Sang-Ho Jo, Chang-Hwan Yoon, Min Gyu Kang, Jin-Sin Koh, Kwan Yong Lee, Young-Hyo Lim, Yun-Hyeong Cho, Jin-Man Cho, Woo Jin Jang, Kook-Jin Chun, David Hong, Taek Kyu Park, Jeong Hoon Yang, Seung-Hyuk Choi, Hyeon-Cheol Gwon, Joo-Yong Hahn
Journal: JACC. Cardiovascular imaging (2023)
A decision tree model to help treatment decision-making for severe spontaneous intracerebral hemorrhage
Authors: Kaiwen Wang, Qingyuan Liu, Shaohua Mo, Kaige Zheng, Xiong Li, Jiangan Li, Shanwen Chen, Xianzeng Tong, Yong Cao, Zhi Li, Jun Wu, Shuo Wang
Journal: International Journal of Surgery (2023)

Background: Surgical treatment demonstrated a reduction in mortality among patients suffering from severe spontaneous intracerebral hemorrhage (SSICH). However, which SSICH patients could benefit from surgical treatment was unclear. This study aimed to establish and validate a decision tree (DT) model to help determine which SSICH patients could benefit from surgical treatment. Materials and methods: SSICH patients from a prospective, multicenter cohort study were analyzed retrospectively. The primary outcome was the incidence of neurological poor outcome (modified Rankin scale as 4-6) on the 180 th day post-hemorrhage. Then, surgically-treated SSICH patients were set as the derivation cohort (from a referring hospital) and validation cohort (from multiple hospitals). A DT model to evaluate the risk of 180-day poor outcome was developed within the derivation cohort and validated within the validation cohort. The performance of clinicians in identifying patients with poor outcome before and after the help of the DT model was compared using the area under curve (AUC). Results: 1260 SSICH patients were included in this study (middle age as 56, and 984 male patients). Surgically-treated patients had a lower incidence of 180-day poor outcome compared to conservatively-treated patients (147/794 vs. 128/466, P &lt;0.001). Based on 794 surgically-treated patients, multivariate logistic analysis revealed the ischemic cerebro-cardiovascular disease history, renal dysfunction, dual antiplatelet therapy, hematoma volume, and Glasgow coma score at admission as poor outcome factors. The DT model, incorporating these above factors, was highly predictive of 180-day poor outcome within the derivation cohort (AUC, 0.94) and validation cohort (AUC, 0.92). Within 794 surgically-treated patients, the DT improved junior clinicians’ performance to identify patients at risk for poor outcomes (AUC from 0.81 to 0.89, P &lt;0.001). Conclusions: This study provided a DT model for predicting the poor outcome of SSICH patients post-surgically, which may serve as a useful tool assisting clinicians in treatment decision-making for SSICH.
Coronary Stenosis Quantification With Ultra-High-Resolution Photon-Counting Detector CT Angiography
Authors: Matthias Eberhard, Alessandro Candreva, Rengarajan Rajagopal, Victor Mergen, Thomas Sartoretti, Barbara E. Stähli, Christian Templin, Robert Manka, Hatem Alkadhi
Journal: JACC. Cardiovascular imaging (2023)
Accuracy of OCT Core Labs in Identifying Vulnerable Plaque
Authors: Aleksandra B. Gruslova, Shashank Singh, Taylor Hoyt, Deborah Vela, Yuliya Vengrenyuk, L. Maximilian Buja, Silvio Litovsky, Joel Michalek, Akiko Maehara, Annapoorna Kini, Takashi Akasaka, Hector M. Garcia-Garcia, Ik-Kyung Jang, Jouke Dijkstra, Lorenz Raber, Thomas E. Milner, Marc D. Feldman
Journal: JACC. Cardiovascular imaging (2023)
Neuroinflammation: An astrocyte perspective
Authors: Hong-Gyun Lee, Joon-Hyuk Lee, Lucas E. Flausino, Francisco J. Quintana
Journal: Science Translational Medicine (2023)

Astrocytes are abundant glial cells in the central nervous system (CNS) that play active roles in health and disease. Recent technologies have uncovered the functional heterogeneity of astrocytes and their extensive interactions with other cell types in the CNS. In this Review, we highlight the intricate interactions between astrocytes, other CNS-resident cells, and CNS-infiltrating cells as well as their potential therapeutic value in the context of inflammation and neurodegeneration.
Is Reducing Heart Failure Hospitalization Associated With Reducing Mortality in Heart Failure Trials?
Authors: Ahmed Sayed, Kamal Awad, Mohamed ElRefaei, Husam M. Salah, Abdelrahman I. Abushouk, Samir Kapadia, Javed Butler, Stefan D. Anker, Marat Fudim, Gianluigi Savarese
Journal: JACC Heart Failure (2023)
Low Performance of ChatGPT on Echocardiography Board Review Questions
Authors: Gyula Kangiszer, Arun Umesh Mahtani, Mark Pintea, Charlotte Jacobs, Hannah Sragovicz, Tai Nguyen, Sahithi Yeturu, Madison Lieberman, Carly Waldman, Sanjeev P. Bhavnani, Melody Hermel
Journal: JACC. Cardiovascular imaging (2023)
Immersive virtual reality simulation training for cesarean section: a randomized controlled trial
Authors: Hyeon Ji Kim, Hee Kyeong Lee, Ji Yeon Jang, Kyong-No Lee, Dong Hoon Suh, Hyoun-Joong Kong, Seung-Hee Lee, Jee Yoon Park
Journal: International Journal of Surgery (2023)

Background: Cesarean section (CS) is a complex surgical procedure that involves many steps and requires careful precision. Virtual reality (VR) simulation has emerged as a promising tool for medical education and training, providing a realistic and immersive environment for learners to practice clinical skills and decision-making. This study aimed to evaluate the educational effectiveness of a VR simulation program in training the management of patients with premature rupture of membranes (PROM) and CS. Materials and Methods: A two-arm parallel randomized controlled trial was conducted with 105 eligible participants randomly assigned to the VR group (n=53) or the control group (n=52) in a 1:1 ratio. The VR group received VR simulation training focused on PROM management and CS practice, while the control group watched a video presentation with narrative of clinical scenario and recording of CS. Both groups completed questionnaires assessing their prior experiences with VR, experience in managing patients with PROM and performing CS, as well as their confidence levels. These questionnaires were administered before and after the intervention, along with a mini-test quiz. Results: Baseline characteristics and previous experiences were comparable between the two groups. After the intervention, the VR group had higher confidence scores in all four aspects, including managing patients with PROM, performing CS as an operator, and understanding the indications and complications of CS, compared to the control group. The VR group also achieved significantly higher scores on the mini-test quiz [median (interquartile range), 42 (37–48) in the VR group; 36 (32–40) in the control group, P &lt;0.001]. Conclusion: VR simulation program can be an effective educational tool for improving participants’ knowledge and confidence in managing patients with PROM and performing CS.
Rate and durability of the clearance of HBsAg in Alaska Native persons with long-term HBV infection: 1982–2019
Authors: Dana Bruden, Brian J. McMahon, Mary Snowball, Lisa Towshend-Bulson, Chriss Homan, Janet M. Johnston, Brenna C. Simons, Michael G. Bruce, Laura Cooley, Philip R. Spradling, Aaron M. Harris
Journal: Hepatology (2023)

Background and Aims: A functional cure and therapeutic end point of chronic HBV infection is defined as the clearance of HBsAg from serum. Little is known about the long-term durability of HBsAg loss in the Alaskan Native population. Approach and Results: We performed a retrospective cohort study of Alaska Native patients with chronic HBV-monoinfection from January 1982 through December 2019. The original group in this cohort was identified during a 1982 to 1987 population-based screening for 3 HBV serologic markers in 53,000 Alaska Native persons. With close to 32,000 years of follow-up, we assessed the frequency and duration of HBsAg seroclearance (HBsAg-negative for &gt; 6 mo). We examined factors associated with HBsAg clearance and followed persons for a median of 13.1 years afterward to assess the durability of HBsAg clearance. Among 1079 persons with an average length of follow-up of 33 years, 260 (24%) cleared HBsAg at a constant rate of 0.82% per person/per year. Of the 260 persons who cleared, 249 (96%) remained HBsAg-negative, while 11 persons had ≥ 2 transient HBsAg-positive results in subsequent follow-up. Conclusions: Of the patients with chronic HBV monoinfection, 0.82% of people per year achieved a functional cure. HBsAg seroclearance was durable for treated and nontreated patients and lasted, on average, over 13 years without seroreversion.
A commentary on ‘Performance of CT-based deep learning in diagnostic assessment of suspicious lateral lymph nodes in papillary thyroid cancer: a prospective diagnostic study’
Authors: Jiangming Qu, Ruichen Gao, Yu Chen
Journal: International Journal of Surgery (2023)

aDepartment of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China bPeking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China Jiangming Qu, Ruichen Gao Jiangming Qu and Ruichen Gao contributed equally to this work. Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. Published online ■ ■ *Corresponding author. Address: Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences. No.1 Shuai Fu Yuan, Dong Cheng District, Beijing 100730, China. E-mail address: [email protected] (Y. Chen). This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0/